Urology and Men's Health Calculators

The International Prostate Symptom Score (IPSS) quantifies lower urinary tract symptoms from 0–35 (7 symptom questions + 1 quality of life item). Mild: 0–7 (watchful waiting); moderate: 8–19 (lifestyle modification, pharmacotherapy discussion); severe: 20–35 (pharmacotherapy or surgical referral). The QoL question ('If you were to spend the rest of your life with your urinary condition the way it is now, how would you feel?') often drives treatment decisions more than the symptom score alone. Serial IPSS tracks treatment response.

PSA density (PSAD) = total PSA ÷ prostate volume (measured by TRUS or MRI). A PSAD >0.15 ng/mL/cc increases the likelihood that an elevated PSA reflects prostate cancer rather than benign prostatic hyperplasia. PSAD is particularly useful in the 4–10 ng/mL 'gray zone' where specificity of PSA alone is low. Higher PSAD is also associated with clinically significant (Gleason ≥7) rather than indolent disease, informing biopsy decisions and active surveillance candidacy.

The CAPRA (Cancer of the Prostate Risk Assessment) score uses PSA, Gleason grade group, clinical T stage, percent positive biopsy cores, and age to stratify risk. Score 0–2 = low risk (5-year biochemical recurrence ~14%); 3–5 = intermediate risk (~46%); 6–10 = high risk (~72%). CAPRA guides treatment selection — low-risk patients may be candidates for active surveillance; high-risk patients typically warrant multimodal therapy. CAPRA-S (post-surgical) predicts recurrence after radical prostatectomy.

PSA doubling time (PSADT) measures the rate of PSA rise over time. PSADT <3 months after primary treatment suggests aggressive systemic disease and warrants early salvage systemic therapy consideration. PSADT 3–12 months indicates intermediate-risk biochemical recurrence. PSADT >12–15 months is generally associated with slower progression and may allow watchful waiting or delayed intervention. PSADT is most meaningful in the setting of biochemical recurrence after radical prostatectomy or radiotherapy.

The International Index of Erectile Function-5 (IIEF-5), also called the Sexual Health Inventory for Men (SHIM), scores 5 questions about erectile function over the past 6 months (score 5–25). Interpretation: 22–25 = no ED; 17–21 = mild ED; 12–16 = mild-to-moderate; 8–11 = moderate; 5–7 = severe ED. IIEF-5 is the most widely used validated tool for ED diagnosis and treatment monitoring in clinical practice and research. A score <22 on two occasions warrants clinical evaluation.

The Overactive Bladder Symptom Score (OABSS) is a 4-item questionnaire assessing daytime frequency, nocturia, urgency, and urgency incontinence. Total score 0–15: 3–5 = mild OAB; 6–11 = moderate; ≥12 = severe. Urgency (question 3) ≥2 is required for OAB diagnosis. OABSS guides treatment escalation: lifestyle modification for mild, anticholinergics or beta-3 agonists (mirabegron) for moderate-severe, and third-line options (PTNS, sacral neuromodulation, botulinum toxin) for refractory cases.